Anderson Hynes pyeloplasty, lots of colorectal cancers and lots of lap choles.
Posted on: April 30, 2007
30.4.07
Six lap choles.
16.4.07
Appendicectomy in a 10 years old male child, s/o dr Tejinder Singh Dhillon our ex-house surgeon, now in Khanna.
2 lap choles.
12.4.07
AH Pyeloplasty in a 10 years old male child with hydronephrosis.
A nephrectomy (R) for a big intrarenal staghorn stone ; the renal hilum bled badly, clamped with vascular clamp and closed over with silk sutures.
Emergency in the evening: cancer rectosigmoid obese 55 F; admitted for more than two weeks in medicine with intestinal obstruction; CT done very late showed nothing but colonoscopy showed the rectosigmoid tumor. An emergency colostomy for obstruction was done by the senior resident (Dr Bharti) two days back but this had retracted and was not working, hence an emergency surgery had been fixed. At operation, an extended right hemicolectomy for a big exophytic tumour in the rectosigmoid with extensive adhesions was performed; the prolonged surgery ended up in a Hartmann’s procedure. However, the patient died on 22nd in the ICU, allegedly of MI.
9.4.07
Another bad colon cancer case: A 50 years old Mr Bahadur had been operated in Malerkotla civil hospital, where the local surgeon (ex PG from this college under Dr Bandlish) did a laparotomy (thru RPM incision!) for perforation of the ileum which was closed; this closure leaked and the patient referred to Rajendra Hospital; our SR reclosed the perforation and found a tumor in the splenic flexure; He did a transverse colostomy.
On exploration by me, dense adhesions were found all around; through a midline laparotomy, an extended right hemicolectomy was performed and an ileosigmoid anastomosis made.
5.4.07
A rectosigmoid cancer in a 50 years old female presented with intestinal obstruction; colostomy 2 weeks back in emergency had been done for obstruction. A sigmoid resection was done today and a colorectal anastomosis performed.
2.4.07
TVGJ for nonhealing ulcer and GOO ; obese 50 M
29.3.07
GJ for GOO: An 80 years old female presented with a short history of gastric outlet obstruction (GOO) and a CT showing a mass (Ca?) in the gall bladder. At operation ,the dense mass in RUQ causing GOO was not disturbed, but a palliative gastrojejunostomy was performed.
26.3.07
5 lap choles one after the other.
22.3.07
APR in a 22 years old male with a low rectal cancer extending into the upper anal canal.
VVF and ileostomy closures
Posted on: March 18, 2007
12.3.07
VVF repair in an obese 50 years old from village (hysterectomy at Samana (dr arora) – fistula for last 2 years). The fistula at the dome of the bladder was repaired abdominally.
15.3.07
2 ileostomy closures; both young men with enteric perforations in the terminal ileum – exteriorized 3 months back.
Branchial cyst
Posted on: February 8, 2007
8.2.2007
A branchial cyst was excised in a 15 years old male. The cyst ruptured during excision was was otherwise excised easily. However, an associated piece of cartilage attached to it was an unusual finding.
Thyroid lobectomy ending up in external jugular vein laceration, a breast conserving lumpectomy for suspicious lump of breast
Posted on: February 1, 2007
1. A neat thyroid lobectomy in a 20 years old female for a follicular adenoma. however, the vacuum suction drain pump rapidly filled up with blood – re-explored to find a laceration in the external jugular vein by the drain trocar. The rent was sutured.
2. A 45 years old female with a 2 cm cystic and solid mass in the superolateral part of right breast on mammograhpy, and clinically impalpable axillary nodes. histopathology was unclear. A lumpectomy and SLN bx was planned; methylene blue did stain a node; but had some other enlarged nodes ; so removed all – sort of axillary clearance was done. At final histopathology, no LN came out to be involved. However, the oncologist decided to go ahead with chemotherapy.
26.1.07
Marriage attended at Kohinoor marriage palace Rajpura road.
25.1.07
Bascom operation for pilonidal sinus – first time; The patient was an intern.
22.1.07
Mehar Singh (worker at Principal Dr Kiranjit Kaur’s farm), a 50 year old male, had perforation (typhoid ileal perforation) peritonitis 4 months back and had the perforation closed. This leaked and then an ileostomy was made. This was now closed.
2 easy lap choles
Posted on: January 15, 2007
15.1.07
1. 35 years old female with an easy gall bladder.
2. 35 years old female with a gall bladder with with a short cystic duct.
11.1.07
Lipoma oral cavity diagnosed as mucus cyst.
Called to help at nephrectomy for big upper pole renal cancer adherent with the liver. The exposure was inadequate.. Improved exposure led to an easy nephrectomy.
Ileocecal tuberculosis misdiagnosed as appendicitis, and a fallacy of perception in lap chole
Posted on: January 8, 2007
7.1.2007
A fallacy of perception at lap chole occurred in a 35 years old talkative lady (relative of daughter-in-law of dr Modi). The long narrow neck of gallbladder was perceived as the cystic duct and thus the dissection remained at a higher level leading to confusions in anatomy, and the cystic artery not being found. A further lower dissection revealed the cystic duct at lower level, with the artery behind it in dense adhesions in the Calot’s triangle.
25 years old male from Jagraon was diagnosed as appendicitis and appendicectomy done at civil hospital Jagraon. Biopsy of appendix was reported as tuberculosis. Was started on antituberculous therapy. Had taken these drugs for 2 months, but continued to have attacks of intestinal obstruction.
At operation, the caecum was found to be contracted and and terminal ileum tightly strictured 2 strictures proximal to cecum along with other multiple strictures proximally. This 15 cm length of terminal ileum with strictures and cecum were excised and EEA done.
4.1.07
OP Sharma a 55 years old obese male with a French-cut beard presented with features of intestinal obstruction. Had a laparotomy previously in 1993 (Dr Mahesh Gupta) for abdominal pain at which probably (no records available) adhesiolysis was done and thereafter the patient was started on ATT (antitubercular therapy) initially for 6 months and then again for one and half years. The symptoms persisted. Dr Pramod, the gastroenterologist, then got a BMFT done. This revealed strictures in the small intestine.
At laparotomy now, dense adhesions were encountered in the RIF. These were lysed. A band obstructing the midileum was divided. And then 3 strictures in the proximal ileum in a segment of 6 inches were resected and an EEA done.
TAH with BSOP with infracolic omentectomy 65 f with previous h/o MRM for breast cancer in 1982. Dr Mohi later reported that the biopsy report turned out to be cancer of the fallopian tube which according to her was rare.
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